en fr Methodological and clinical evaluation of markers of the lung injury in exhaled breath : comparison of subjects with chronic respiratory disease and controls Évaluation méthodologique et clinique des marqueurs de l’atte - Download this document for free, or read online. Document in PDF available to download.

1 Impact de l-environnement chimique sur la santé humaine

Abstract : The study of both volatile FeNO and non-volatile respiratory biomarkers using the method of exhaled breath condensates can be useful in medical surveillance of exposed workers, the early identification of respiratory diseases or in the monitoring of their development. Studies of exhaled NO FeNO is now well standardized and the exponential increase in publications on exhaled breath condensate EBC reflects growing interest in a non-invasive diagnosis of pulmonary diseases. The biomarkers studied are products of inflammation, such as FeNO and cytokines, and products of oxidative stress, including hydrogen peroxide H202, products of lipid peroxydation 8-isoprostane, malondialdehyde and nitrogen oxides. The first recommendation was published in 2005 but although many recent publications have applied this new method, numerous methodological pitfalls remain and still described in 2012. They concern all the stages of the collection to the analysis.Objectives: The main objective of this research was initially to develop the method of EBC for the study of compounds of exhaled air and then detect and quantify biomarkers such as total protein, NOx and 8-isoprostane in exhaled air in a population of healthy adults n = 48 or patients with lung inflammatory diseases such as asthma n = 24, COPD n = 20, diffuse interstitial pneumonia n = 27 and scleroderma n = 27. The secondary objective was to compare levels of biomarkers measured in the EBC and FeNO in patients compared to controls.Results - conclusion: Our research, supported by ANR and ANSES, allowed to standardize the methodology of collection and analysis of EBC with a choice of the collection system and coating which must be effective and compatible with the analyzes. In EBC, we control the dosage of biomarkers such as proteins, NOx and 8-isoprostane. Other biomarkers are still being studied such as malondialdehyde and cytokines. This published methodological study, allowed in a second step the detection > 95% and quantification of these biomarkers in EBC of healthy patients in our population.Perspectives: This standardization is a key epidemiological requirement for the task force on the establishment of reference values and the publication of methodological guidelines so as to realize the promise of this approach for clinical studies of lung diseases. We have also to finish the development of biomarkers such as cytokines or malondialdehyde and to investigate new biomarkers to complete the pathophysiological mechanisms. Finally our objective is the widespread use of this noninvasive method in daily epidemiological studies on subjects with professional and-or environmental exposure. In this context, the study of markers of the toxic burden in the lungs such as heavy metals in the EBC is being developed.

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